11 CT scan The British engineer Godfrey Hounsfield demonstrated the first CT scanner in For this invention, he received the Nobel Prize in medicine in 1979.

12 MRI scan Paul Lauterbur

13 Lancet Nov 14;2(8255): Nuclear magnetic resonance imaging of the brain in multiple sclerosis Young IR, Hall AS, Pallis CA, Legg NJ, Bydder GM, Steiner RE. Ten patients with multiple sclerosis (MS) were scanned by means of cranial X-ray computed tomography (CT) with and without intravenous contrast enhancement, and by nuclear magnetic resonance (NMR) using an inversion-recovery sequence. Altogether 19 lesions varying in size between about 7 mm X 5 mm and 13 mm X 8 mm were demonstrated by CT. They were all situated in the periventricular region. Two patients also showed moderate ventricular enlargement. In addition to these abnormalities 112 further lesions were demonstrated on the NMR scans. These lesions varied in size from 4 mm X 3 mm to 12 mm X 7 mm and were particularly well seen in the periventricular region and brainstem. Care is required in the assessment of NMR scans to exclude artefacts, background noise, and mottle as well as normally situated grey matter and partial volume effects from cerebral sulci. NMR nevertheless demonstrates abnormalities in MS on a scale not previously seen except at necropsy.

19 Clin Neurol Neurosurg. 1975;78(1): Treatment of the chronic progressive form of multiple sclerosis with a combination of cyclophosphamide and prednisone. Hommes OR, Prick JJ, Lamers KJ. 32 patients with the chronic progressive form of the multiple sclerosis were treated with high doses of cyclophosphamide and prednisone during 20 days, to produce immunosuppression. The effect of treatment was measured by scoring three different Kurtzke scales just before treatment (1), just after treatment (II), and 3 months after treatment (III). The results indicate that in the treatment period I to II most patients improve, some dramatically. The improvement continues in 15 of 25 patients scored between 6 and 33 months after treatment. Better results were found in patients with shorter duration of their disease. More improvement is found as the IgG percentage of the spinal fluid at I is higher. The improvement is less when the initial condition (I) is more serious.

20 Clin Neurol Neurosurg. 1975;78(1): Treatment of the chronic progressive form of multiple sclerosis with a combination of cyclophosphamide and prednisone. Hommes OR, Prick JJ, Lamers KJ. 32 patients with the chronic progressive form of the multiple sclerosis were treated with high doses of cyclophosphamide and prednisone during 20 days, to produce immunosuppression. The effect of treatment was measured by scoring three different Kurtzke scales just before treatment (1), just after treatment (II), and 3 months after treatment (III). The results indicate that in the treatment period I to II most patients improve, some dramatically. The improvement continues in 15 of 25 patients scored between 6 and 33 months after treatment. Better results were found in patients with shorter duration of their disease. More improvement is found as the IgG percentage of the spinal fluid at I is higher. The improvement is less when the initial condition (I) is more serious.

21

22 Dr. J.F. Kurzke

23 EDSS score

24 MS zorg Neurology Nov;33(11): Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Kurtzke JF One method of evaluating the degree of neurologic impairment in MS has been the combination of grades (0 = normal to 5 or 6 = maximal impairment) within 8 Functional Systems (FS) and an overall Disability Status Scale (DSS) that had steps from 0 (normal) to 10 (death due to MS). A new Expanded Disability Status Scale (EDSS) is presented, with each of the former steps (1,2,3... 9) now divided into two (1.0, 1.5, ). The lower portion is obligatorily defined by Functional System grades. The FS are Pyramidal, Cerebellar, Brain Stem, Sensory, Bowel & Bladder, Visual, Cerebral, and Other; the Sensory and Bowel & Bladder Systems have been revised. Patterns of FS and relations of FS by type and grade to the DSS are demonstrated.

De Invloed van Chronische Pijn en de Modererende Invloed van Geslacht op de Ervaren Sociale Steun The Effect of Chronic Pain and the Moderating Effect of Gender on Perceived Social Support Studentnummer:

Multiple sclerose Zwanikken, Cornelis Petrus IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document

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